By Maxine Frith
Vegan and macrobiotic diets have led to the return of rickets in Britain, according to experts. They say cases among children are rising, more than 50 years after the disease was virtually eradicated by better health and nutrition.
Doctors have blamed a variety of factors, including the fact that children are failing to get enough vitamin D, either because they are fed too much junk food or are on vegan and macrobiotic diets which ban dairy products.
Fears over skin cancer mean that children are not being exposed to enough direct sunlight, another source of vitamin D. Children who are left in daycare facilities for long periods, where they spend most of the time indoors, may also be more vulnerable.
Brian Wharton, an adviser to the government and the World Health Organisation on child nutrition, highlighted the return of rickets in a paper published in the medical journal The Lancet. He said: "An old problem of nutritional child health, once thought vanquished, has resurfaced."
It is thought that hundreds of children in Britain may be developing rickets every year. Many cases may go undetected because doctors are so unused to seeing the symptoms.
Rickets is caused by a lack of vitamin D, which is stored in the body from food and from exposure to sunlight. The classic signs are bow legs caused by softening of the bones. It is most common among children between the ages of six months and two years, and, if not detected early, can need surgery to correct its crippling effects.
The disease was common among malnourished children of the Victorian era but was eradicated by the 1950s.
But Mr Wharton said that modern lifestyles and health concerns were contributing to the return of the disease.
The main source of vitamin D is sunlight, with foods such as cows' milk and oily fish also providing essential bone-strengthening supplies. But the increasing use of sunscreen means that children's skin is not being exposed to UV rays which produce the vitamin, while certain diets ban the foods containing it.
Mr Wharton said: "Possible reasons for the increasing prevalence of rickets in older infants and toddlers include... extensive use of sunscreens, increased use of daycare facilities where children stay indoors much of the time, unusual diets and soy health-food beverages that provide little vitamin D and calcium."
He called for all children to be given vitamin D supplements in an attempt to prevent the return of an epidemic.
A report by the Royal College of Paediatrics last year found that five percent of children were not getting enough vitamin D.
There are an estimated 250 000 vegans in Britain, and increasing numbers of people are following the type of macrobiotic diet favoured by celebrities such as Gwyneth Paltrow and Madonna. One in 10 teenaged girls are vegetarian or vegan, according to the Food Standards Agency.
Earlier this year, a New York couple were convicted of endangering the life of their 15-month-old daughter by subjecting her to a strict vegan diet which left her malnourished and suffering from rickets. Silva Swinton and her husband Joseph were jailed after what was seen as a test case for parents who put their children on such diets.
A spokesman for The Vegan Society said: "Being vegan is a health and a moral choice, and a vegan diet can be followed without suffering from vitamin loss."